不同时间窗内采用不同术式治疗高血压脑出血的临床效果分析

摘要

ObjectiveTo analyze clinical effects by different operating measures during different time window in the treatment of hypertensive cerebral hemorrhage.MethodsA total of 90 patients with hypertensive cerebral hemorrhage were divided by different operating measures into stereotactic hematoma puncture group (received stereotactic hematoma puncture for treatment, 51 cases) and small skull-window operation group (received small skull-window operation for treatment, 39 cases). The patients were also divided by different operating interval after disease attack into <6 h or >24 h group (36 cases) and 6~24 h group (54 cases). Comparison was made on disability rate, delayed rehemorrhage rate, total effective rate and national institutes of health stroke scale (NIHSS) score between different operating measures groups. Disability rate and delayed rehemorrhage rate were compared between different time window groups.ResultsThere was no statistically significant difference of disability rate, NIHSS score in postoperative 4 weeks and delayed rehemorrhage rate between the small skull-window operation group and the stereotactic hematoma puncture group (P>0.05). The small skull-window operation group had total effective rate as 64.1%. Comparing with 62.7% in the stereotactic hematoma puncture group, their difference had no statistical significance (P>0.05). The 6~24 group had obviously lower disability rate and delayed rehemorrhage rate than the <6 h or >24 h group, and the difference had statistical significance (P<0.05).ConclusionRational operating measure selection in accordance with individual situation of hypertensive cerebral hemorrhage patients within 6~24 h of disease attack can provide ideal curative effect.%目的：分析不同时间窗内采用不同术式治疗高血压脑出血的临床效果。方法90例高血压脑出血患者,按术式不同分为立体定向血肿穿刺术组(采取立体定向血肿穿刺术治疗,51例)和小骨窗开颅手术组(采取小骨窗开颅手术治疗,39例)。按照患者发病后至手术时间间隔不同分为<6 h或>24 h组(36例)和6~24 h组(54例)。比较不同术式患者病残率、迟发再出血率、总有效率、神经功能缺损评分(NIHSS)；比较不同时间窗患者病残率、迟发再出血率。结果小骨窗开颅手术组与立体定向血肿穿刺术组患者病残率、手术4周后NIHSS评分及迟发再出血率比较差异均无统计学意义(P>0.05)。小骨窗开颅手术组治疗总有效率为64.1%,与立体定向血肿穿刺术组的62.7%比较差异无统计学意义(P>0.05)。6~24 h组患者病残率及迟发再出血率均明显低于<6 h或>24 h组,差异具有统计学意义(P<0.05)。结论依据高血压脑出血患者具体情况合理选择术式,并在发病6~24 h内为患者进行治疗所得效果更为理想。